Pressure Injury Recurrence After Flap Surgery in Home-Dwelling Patients With Spinal Cord Injury in Norway: A Retrospective Study.

A retrospective single-centre study. To investigate the period prevalence of pressure injury recurrence (PIR) and characteristics associated with PIR in the population of persons with spinal cord injury (SCI) who were treated with flap surgery between 2008 and 2019. A spinal cord unit (SCU) in Norway. The study is based on analysis of patient data from the electronic medical record. Crosstabs and logistic regression were used to investigate the potential correlations between the odds of PIR and potential risk characteristics. We identified 54 patients who were treated with flap surgery in the period of interest, and 47 (87%) were men. The mean age for flap surgery was 51 years (SD = 12.7). The occurrence of PIR post-flap surgery was 46% (n = 25). Factors associated with increased risk of PIR were use of manual wheelchair (65% vs. 32%, odds ratio [OR] = 3.9, 95% confidence interval [CI] = 1.06-14.33, p = 0.04) when compared with powered wheelchair, and history of PI and flap surgery at the ischial tuberosity (sit bones) (68% vs. 24%, OR = 3.67, 95% CI = 1.01-13.40, p = 0.04) compared with all other body locations. Factors associated with decreased risk of PIR were independence in position changes (29% vs. 58%, OR = 0.29, 95% CI = 0.91-0.95, p = 0.04) compared with not needing assistance with position changes, tetraplegia (C5-C8) (21% vs. 60%, OR = 0.18, CI = 0.04-0.83, p = 0.02) compared with paraplegia, and postoperative follow-up by the SCU (15% vs. 55%, OR = 0.28, 95% CI 0.03-0.76, p = 0.04) compared with no follow-up from the SCU, as well assistance from personal assistant follow-up (PAF) (26% vs. 56%, OR = 0.15, 95% CI = 0.03-0.76, p = 0.01) compared with not receiving assistance from PAF. The period prevalence of PIR post-flap surgery in the Norwegian population of people with SCI is high and increased odds of PIR were related to flap surgery on the sit bones. Reduced odds of PIR were related to tetraplegia, powered wheelchair use, follow up by PAF and the SCU. The study is registered in the Open science framework.